Hepatitis C Testing, Treatment Lacking in State Prisons

Epidemiologists have said that California's prisons serve as "incubators for communicable diseases," such as hepatitis C, but according to state Department of Corrections records, only about one out of every 14 inmates diagnosed with the virus receives treatment, the Sacramento Bee reports. Prison inmates often transmit the disease -- which can lead to liver cancer and cirrhosis and represents the "leading cause" of liver transplants -- through high-risk behaviors such as needle sharing and unprotected sex. According to a 1999 state Department of Health Services study, an "alarming" 33% of California inmates who entered state prisons had hepatitis C. State officials in September identified 14,305 inmates with hepatitis C in the state's 160,000-member prison population, but based on the 1999 study, more than 50,000 state inmates could have the virus. Only 796 inmates statewide received drug treatment. Lawmakers have only authorized mandatory testing for tuberculosis, not hepatitis C. State inmates only receive a hepatitis C test at the request of a prison doctor, even though the CDC and NIH have recommended routine testing of high-risk populations, such as prison inmates. According to inmate advocates, the state "isn't interested in knowing the extent of the problem" with hepatitis C in prisons. "Treatment costs money, and the Corrections Department is in no hurry to find out how many people need treatment," Judy Greenspan of California Prison Focus said. Drug treatment for hepatitis C can cost up to $20,000 per year, and liver transplants can cost an additional $250,000, the Bee reports. Prison officials said that inmates diagnosed with hepatitis C receive treatment "consistent" with NIH and CDC recommendations (Rojas, Sacramento Bee, 11/26).

Meanwhile, the Los Angeles Daily News reports that the Los Angeles County Board of Supervisors has "pushed" Sheriff Lee Baca to "do more -- and quickly" -- to improve medical and mental health care for the county's 20,000 prison inmates. The board hopes to avoid a potential multimillion dollar lawsuit and a subsequent federal consent decree -- a court-approved agreement that settles lawsuits against public entities and allows outside authorities, such as the U.S. Department of Justice, to oversee their operations. The department began an investigation of Los Angeles County prisons in 1996 and found "chronic" understaffing, "woeful" medical care, "excessive" waiting lists for physician visits, medication errors and inadequate medical tracking systems. Officials in the Sheriff's office called the problems "serious" but said they "need more money to fix" the county's prison system, the largest in the nation. During a "heated" two-hour discussion at a county Board of Supervisors meeting earlier this month, board members told Baca to use $50 million from the Inmate Welfare Fund to hire additional medical staff for county prisons. Baca, however, whose "relationship with the board has turned combative," hopes to hire 71 nurses and doctors and obtain federal certification for the county's prisons as "accredited medical providers." Baca offered to use $2.5 million per year from the inmate fund to cover the cost of the additional staff "if the supervisors would kick in" $2.5 million per year from the county's general fund (Anderson, Los Angeles Daily News, 11/25).